NPI | 1538534771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R242089) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R242089) |
Enumeration Date | 2015-12-13 |
Last Update Date | 2020-04-15 |