NPI | 1205839727 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 12004) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 851973) |
Enumeration Date | 2005-05-30 |
Last Update Date | 2025-03-17 |