NPI | 1255545380 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7764) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN84688) |
Enumeration Date | 2007-05-09 |
Last Update Date | 2025-07-28 |