NPI | 1194467266 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 116717) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 89572) |
Enumeration Date | 2022-04-10 |
Last Update Date | 2023-06-28 |