NPI | 1649226168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA538) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N31597) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2023-09-29 |