NPI | 1346769718 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9266597) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9266597) |
Enumeration Date | 2017-09-16 |
Last Update Date | 2018-06-16 |