NPI | 1639622616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN282661) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 217316) |
Enumeration Date | 2016-07-26 |
Last Update Date | 2024-03-26 |