NPI | 1164748943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 64127) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WV 64127) |
Enumeration Date | 2010-04-19 |
Last Update Date | 2020-12-30 |