NPI | 1235679481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 639761-1) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 639761) |
Enumeration Date | 2017-03-06 |
Last Update Date | 2023-06-29 |