NPI | 1275086852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024178326) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R186171) |
Enumeration Date | 2016-07-29 |
Last Update Date | 2025-01-29 |