NPI | 1912685488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA GAA-CRNA001582) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ14870700) |
Enumeration Date | 2023-07-06 |
Last Update Date | 2024-11-27 |