NPI | 1902445984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7778) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11005440) |
Enumeration Date | 2019-12-23 |
Last Update Date | 2025-05-20 |