NPI | 1396269338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000820) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 792212) |
Enumeration Date | 2017-08-01 |
Last Update Date | 2022-07-16 |