NPI | 1487264966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7891) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 230496) |
Enumeration Date | 2020-08-09 |
Last Update Date | 2025-07-11 |