NPI | 1659990901 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-124992) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11022625) |
Enumeration Date | 2020-04-15 |
Last Update Date | 2023-02-09 |