NPI | 1457834160 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN679958) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00928900) |
Enumeration Date | 2018-09-09 |
Last Update Date | 2024-11-19 |