NPI | 1386286805 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 27019) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 227305) |
367500000X Nurse Anesthetist, Certified Registered (Licence: KY 4025380) | |
Enumeration Date | 2019-10-16 |
Last Update Date | 2024-08-29 |