NPI | 1750713467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5698) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK NURR36126) |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR13968700) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: AK NURR36126) | |
Enumeration Date | 2013-08-05 |
Last Update Date | 2024-07-30 |