NPI | 1932792751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 134304) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 111961-23) |
Enumeration Date | 2021-02-12 |
Last Update Date | 2024-09-11 |