NPI | 1366940009 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 24097) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN233459) |
Enumeration Date | 2018-01-29 |
Last Update Date | 2022-01-28 |