NPI | 1346717360 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 892212) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3017555) |
Enumeration Date | 2018-10-29 |
Last Update Date | 2022-04-14 |