NPI | 1861154080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 31173) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 207430) |
Enumeration Date | 2021-10-06 |
Last Update Date | 2022-02-05 |