NPI | 1750097937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11028316) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH RN.453203) |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL 9620518) | |
Enumeration Date | 2023-01-30 |
Last Update Date | 2023-11-08 |