NPI | 1881157600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 28830) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001124) |
Enumeration Date | 2019-04-09 |
Last Update Date | 2021-04-20 |