NPI | 1629759857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95002186) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95076500) |
Enumeration Date | 2023-07-31 |
Last Update Date | 2023-12-13 |