NPI | 1578927935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60660939) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GU 100429) |
Enumeration Date | 2016-04-11 |
Last Update Date | 2025-06-09 |