NPI | 1699416677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WY 50297) |
Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: WI 250070-30) |
Enumeration Date | 2022-04-05 |
Last Update Date | 2022-08-23 |