NPI | 1669753265 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 17683) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 103304) |
Enumeration Date | 2011-09-09 |
Last Update Date | 2024-03-25 |