NPI | 1811441975 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000666) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 731704) |
367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP09500) | |
Enumeration Date | 2016-08-06 |
Last Update Date | 2021-01-27 |