NPI | 1689397457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 653753) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN653753) |
Enumeration Date | 2022-09-26 |
Last Update Date | 2022-11-16 |