NPI | 1316390735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000635) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 751888) |
Enumeration Date | 2016-07-20 |
Last Update Date | 2022-07-21 |