NPI | 1447494356 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 3885) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 3885) |
Enumeration Date | 2009-04-22 |
Last Update Date | 2023-07-17 |