NPI | 1912252511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 90361) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 293498) |
Enumeration Date | 2012-07-19 |
Last Update Date | 2023-01-03 |