NPI | 1558458042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 2163) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 136101) |
Enumeration Date | 2006-10-06 |
Last Update Date | 2025-06-19 |