NPI | 1346810793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95002110) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R242988) |
Enumeration Date | 2021-06-28 |
Last Update Date | 2023-09-06 |