NPI | 1124718911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN697025) |
Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: PA RN697025) |
Enumeration Date | 2023-05-15 |
Last Update Date | 2023-10-20 |