NPI | 1518403617 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-148906) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 087836-23) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901421) | |
Enumeration Date | 2017-01-12 |
Last Update Date | 2023-02-28 |