NPI | 1932768801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 123428) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN134258) |
367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN134258) | |
Enumeration Date | 2019-06-13 |
Last Update Date | 2021-06-17 |