NPI | 1366789570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002939) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R079036) |
Enumeration Date | 2013-01-08 |
Last Update Date | 2020-06-25 |