NPI | 1629687751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1003368) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 30224) |
Enumeration Date | 2020-07-24 |
Last Update Date | 2025-09-26 |