NPI | 1912408709 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2315467) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI APRN01775) |
Enumeration Date | 2018-02-27 |
Last Update Date | 2018-02-27 |