NPI | 1568947810 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5964) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 229358) |
Enumeration Date | 2018-10-02 |
Last Update Date | 2022-04-14 |