NPI | 1568980472 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000796) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 849532) |
Enumeration Date | 2017-08-31 |
Last Update Date | 2019-07-05 |