NPI | 1508534538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 147178) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM 77111) |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 0000249710) | |
Enumeration Date | 2021-09-03 |
Last Update Date | 2024-01-02 |