NPI | 1417529124 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6813) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 276974) |
Enumeration Date | 2021-07-13 |
Last Update Date | 2022-01-19 |