NPI | 1497179584 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 5033) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: SC 208200) |
Enumeration Date | 2014-02-10 |
Last Update Date | 2020-10-27 |