NPI | 1801278940 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 24281) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 700304) |
Enumeration Date | 2015-06-25 |
Last Update Date | 2024-09-23 |