NPI | 1649787326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001417) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 117527) |
Enumeration Date | 2018-01-04 |
Last Update Date | 2021-02-15 |