NPI | 1205237955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 677299) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 677299) |
163W00000X Registered Nurse (Licence: CA 95000168) | |
Enumeration Date | 2014-09-12 |
Last Update Date | 2024-02-15 |