NPI | 1235793134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 86131) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 103459) |
Enumeration Date | 2019-04-25 |
Last Update Date | 2023-08-04 |