NPI | 1609539667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN667887) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN667887) |
Enumeration Date | 2021-10-18 |
Last Update Date | 2021-12-13 |