NPI | 1285690446 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 2814) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 525610) |
Enumeration Date | 2006-04-25 |
Last Update Date | 2022-02-11 |