NPI | 1558353136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 213) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 153039) |
Enumeration Date | 2005-08-18 |
Last Update Date | 2025-07-07 |