NPI | 1861827636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000025) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 795608) |
Enumeration Date | 2013-09-11 |
Last Update Date | 2019-08-12 |