NPI | 1104204734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 064668-23) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0106567) |
163W00000X Registered Nurse (Licence: NH 064668-21) | |
163W00000X Registered Nurse (Licence: MA RN2290561) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2290561) | |
Enumeration Date | 2015-05-15 |
Last Update Date | 2023-10-27 |