NPI | 1124733555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95002412) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MA RN2351699) |
Enumeration Date | 2023-01-19 |
Last Update Date | 2024-08-14 |