NPI | 1730923319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 834736) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 834736) |
Enumeration Date | 2024-06-19 |
Last Update Date | 2024-06-19 |