NPI | 1710523659 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 29548) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R202526) |
Enumeration Date | 2019-11-26 |
Last Update Date | 2024-11-14 |