NPI | 1619479797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R217862) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 768650) |
367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000925) | |
Enumeration Date | 2018-03-05 |
Last Update Date | 2019-03-05 |