NPI | 1720559677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 124313) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 290232) |
Enumeration Date | 2018-12-17 |
Last Update Date | 2022-06-27 |