NPI | 1528798568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024190273) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2255A2300X Specialist/Technologist, Athletic Trainer | |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: WV 97080) | |
Enumeration Date | 2022-06-13 |
Last Update Date | 2024-07-09 |