NPI | 1194506477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 78567) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 10196201-3102) |
Enumeration Date | 2023-10-11 |
Last Update Date | 2024-01-18 |