NPI | 1790298107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 23725) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 171488) |
Enumeration Date | 2017-11-07 |
Last Update Date | 2018-03-22 |