NPI | 1740724889 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C003169) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R095772) |
Enumeration Date | 2016-12-08 |
Last Update Date | 2021-06-18 |