NPI | 1295155141 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 286500000X Military Hospital (Licence: GA RN226805) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5886) |
Enumeration Date | 2014-04-18 |
Last Update Date | 2025-02-05 |