NPI | 1114246790 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3982) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 702116) |
Enumeration Date | 2010-05-22 |
Last Update Date | 2022-02-11 |