NPI | 1689000101 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA RN210166) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9290091) |
Enumeration Date | 2013-09-16 |
Last Update Date | 2022-11-10 |