NPI | 1922385442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D161761) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ND R37053) |
Enumeration Date | 2011-11-11 |
Last Update Date | 2024-08-05 |