NPI | 1316587306 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN613489) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN613489) |
Enumeration Date | 2020-01-08 |
Last Update Date | 2023-02-16 |