NPI | 1609385756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000872) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 825669) |
Enumeration Date | 2017-09-20 |
Last Update Date | 2022-07-21 |