NPI | 1205353018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000773) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 843567) |
Enumeration Date | 2017-08-23 |
Last Update Date | 2018-06-29 |