NPI | 1689309593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1096015) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D185371) |
Enumeration Date | 2022-07-24 |
Last Update Date | 2025-09-18 |