NPI | 1861236721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1169454) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 819095) |
Enumeration Date | 2024-06-24 |
Last Update Date | 2024-08-16 |