NPI | 1295421584 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA rn278196) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN278196) |
Enumeration Date | 2023-04-11 |
Last Update Date | 2024-01-30 |