NPI | 1043568892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 847A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-36657) |
Enumeration Date | 2012-08-28 |
Last Update Date | 2022-07-21 |