NPI | 1609388784 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9320955) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9320955) |
Enumeration Date | 2017-10-30 |
Last Update Date | 2018-01-18 |