NPI | 1467196469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 0997628-CRNA) |
Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: CO 1621817) |
Enumeration Date | 2022-04-25 |
Last Update Date | 2022-06-14 |