NPI | 1558900159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 211607) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN151347) |
Enumeration Date | 2019-12-30 |
Last Update Date | 2023-01-06 |