NPI | 1386981777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 8200) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 8200) |
Enumeration Date | 2013-01-07 |
Last Update Date | 2023-01-26 |