NPI | 1851049399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 11293) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704278148) |
Enumeration Date | 2022-03-14 |
Last Update Date | 2023-11-27 |