NPI | 1639727878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 26540) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN203726) |
Enumeration Date | 2019-08-30 |
Last Update Date | 2019-12-26 |