NPI | 1821794538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 27653) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PR 124736) |
Enumeration Date | 2023-02-03 |
Last Update Date | 2023-10-03 |