NPI | 1699757872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R861940) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 4043426) |
Enumeration Date | 2005-11-15 |
Last Update Date | 2025-09-05 |