NPI | 1518764802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11040665) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9539710) |
Enumeration Date | 2025-02-25 |
Last Update Date | 2025-08-04 |