NPI | 1578970752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000157) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 756752) |
Enumeration Date | 2014-07-19 |
Last Update Date | 2021-12-01 |