NPI | 1881375657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AL 1-174846) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209030865) |
Enumeration Date | 2023-07-26 |
Last Update Date | 2024-10-28 |