NPI | 1457962011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001995) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 848209) |
Enumeration Date | 2020-08-16 |
Last Update Date | 2023-09-11 |