NPI | 1033554183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID n-45970) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC RN.215484R) |
Enumeration Date | 2013-05-02 |
Last Update Date | 2018-03-17 |