NPI | 1588458640 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10045955) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201807567RN) |
Enumeration Date | 2025-04-05 |
Last Update Date | 2025-06-25 |