NPI | 1104330281 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 100733) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0100733) |
Enumeration Date | 2017-11-27 |
Last Update Date | 2020-01-30 |