NPI | 1083004154 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R192422) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R192422) |
Enumeration Date | 2015-01-28 |
Last Update Date | 2021-12-08 |