NPI | 1598007759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024170670) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001209401) |
Enumeration Date | 2013-03-26 |
Last Update Date | 2021-07-28 |