NPI | 1518531482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 25026930) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2021046373) |
Enumeration Date | 2021-05-16 |
Last Update Date | 2025-02-19 |