NPI | 1649341330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 2272) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 167236) |
367500000X Nurse Anesthetist, Certified Registered (Licence: TN 054073) | |
Enumeration Date | 2006-11-13 |
Last Update Date | 2023-04-05 |