NPI | 1669942074 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101525) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 111032) |
367500000X Nurse Anesthetist, Certified Registered (Licence: IA D154760) | |
Enumeration Date | 2018-11-28 |
Last Update Date | 2019-06-13 |