NPI | 1225768419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 116916) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 88738) |
367500000X Nurse Anesthetist, Certified Registered (Licence: WV 1225768419) | |
Enumeration Date | 2022-06-13 |
Last Update Date | 2023-09-06 |