NPI | 1598391435 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 294796) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 294796) |
367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10009609) | |
Enumeration Date | 2020-03-22 |
Last Update Date | 2023-08-17 |