NPI | 1538807771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 010660) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 137393) |
Enumeration Date | 2022-05-26 |
Last Update Date | 2022-07-07 |