NPI | 1295519072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D176251) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 223057) |
Enumeration Date | 2023-08-22 |
Last Update Date | 2023-12-04 |