NPI | 1285208215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 138459) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95030642) |
Enumeration Date | 2021-05-14 |
Last Update Date | 2021-09-08 |