NPI | 1407586571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN673403) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN673403) |
Enumeration Date | 2022-06-13 |
Last Update Date | 2023-12-04 |