NPI | 1134660574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 96642) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AR R098277) |
Enumeration Date | 2017-03-18 |
Last Update Date | 2018-01-15 |