NPI | 1861725467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3843) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 97599) |
163W00000X Registered Nurse (Licence: CA 651370) | |
Enumeration Date | 2009-09-14 |
Last Update Date | 2022-01-03 |