NPI | 1063003648 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2329584) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MA RN2329584) |
Enumeration Date | 2021-01-27 |
Last Update Date | 2024-07-11 |