NPI | 1235696147 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 26130) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 188988) |
Enumeration Date | 2019-02-27 |
Last Update Date | 2019-07-24 |