NPI | 1740986066 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11022557) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9612491) |
Enumeration Date | 2023-02-07 |
Last Update Date | 2023-02-07 |