NPI | 1497322879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 28277) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 240231) |
Enumeration Date | 2021-06-05 |
Last Update Date | 2024-05-13 |