NPI | 1700407145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61077181) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APN.29452) |
Enumeration Date | 2020-04-27 |
Last Update Date | 2025-08-08 |