NPI | 1912365362 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA173041) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 280378) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: ME 62949) | |
Enumeration Date | 2016-01-31 |
Last Update Date | 2018-01-04 |