NPI | 1386799252 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 85894) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 0085894) |
Enumeration Date | 2007-01-23 |
Last Update Date | 2022-06-28 |