NPI | 1144740374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61104694) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9315958) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA AP61104694) | |
363L00000X Nurse Practitioner (Licence: FL 9315958) | |
Enumeration Date | 2017-06-20 |
Last Update Date | 2021-11-01 |