NPI | 1033834569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D172514) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 218705-7) |
Enumeration Date | 2022-10-06 |
Last Update Date | 2023-06-29 |