NPI | 1700495264 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6428) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.393168) |
Enumeration Date | 2020-07-30 |
Last Update Date | 2020-09-22 |