NPI | 1336636604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00852700) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 122088) |
Enumeration Date | 2018-04-22 |
Last Update Date | 2023-08-01 |