NPI | 1861075418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 66205) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1045301) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: AR 136546) | |
Enumeration Date | 2021-05-02 |
Last Update Date | 2022-01-04 |