NPI | 1811737588 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA APRN-CRNA287153) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN287153) |
Enumeration Date | 2024-05-29 |
Last Update Date | 2025-10-03 |