NPI | 1821505280 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN283519) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 059871-23) |
Enumeration Date | 2018-01-08 |
Last Update Date | 2023-08-30 |