NPI | 1013534346 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10014902) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR 201705526RN) |
Enumeration Date | 2020-07-02 |
Last Update Date | 2024-01-09 |