NPI | 1871398230 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: FL APRN11039747) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9441278) |
Enumeration Date | 2025-02-18 |
Last Update Date | 2025-05-27 |