NPI | 1518028240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 2603) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 351609) |
Enumeration Date | 2006-12-13 |
Last Update Date | 2022-01-03 |