NPI | 1861110850 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11026295) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9478070) |
Enumeration Date | 2022-08-16 |
Last Update Date | 2023-05-23 |