NPI | 1609347962 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1070648) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 75999) |
367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101528) | |
Enumeration Date | 2018-12-16 |
Last Update Date | 2023-07-25 |