NPI | 1285291989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 126138) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 22892) |
Enumeration Date | 2019-05-29 |
Last Update Date | 2022-04-14 |