NPI | 1205358801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 31309) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN288846) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-07-14 |
Last Update Date | 2022-07-21 |