NPI | 1902270911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704266309) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704266309) |
Enumeration Date | 2015-11-15 |
Last Update Date | 2020-05-29 |