NPI | 1639610330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 220350) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9387609) |
Enumeration Date | 2017-03-14 |
Last Update Date | 2024-02-24 |