NPI | 1780174300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28209517A) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 122217) |
Enumeration Date | 2018-05-18 |
Last Update Date | 2023-11-21 |