NPI | 1427611227 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 120419) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2024049483) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-17 |
Last Update Date | 2025-01-20 |