NPI | 1285404053 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 216547) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1148571) |
Enumeration Date | 2024-01-03 |
Last Update Date | 2024-05-13 |