NPI | 1225600273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 139765) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NC 228800) |
Enumeration Date | 2021-07-10 |
Last Update Date | 2022-11-02 |