NPI | 1558035527 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61201940) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 149114) |
Enumeration Date | 2021-08-04 |
Last Update Date | 2022-01-25 |