NPI | 1467024943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 142685) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 89560) |
Enumeration Date | 2021-07-14 |
Last Update Date | 2023-01-19 |