NPI | 1003367574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 22217) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 164147) |
Enumeration Date | 2016-10-20 |
Last Update Date | 2021-07-27 |