NPI | 1750366274 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 162885) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 520570-1) |
Enumeration Date | 2005-12-07 |
Last Update Date | 2023-09-07 |