NPI | 1164846275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000065) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA RN 585430) |
Enumeration Date | 2014-02-10 |
Last Update Date | 2022-02-11 |