NPI | 1811619398 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 32389) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 207191) |
Enumeration Date | 2022-09-13 |
Last Update Date | 2022-09-13 |