NPI | 1194875112 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 075318) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 162260) |
Enumeration Date | 2007-01-11 |
Last Update Date | 2020-07-24 |