NPI | 1750170304 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7839) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 154788) |
Enumeration Date | 2025-05-01 |
Last Update Date | 2025-07-08 |