NPI | 1295050011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 4227) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 103190) |
Enumeration Date | 2010-04-05 |
Last Update Date | 2024-01-25 |