NPI | 1942314117 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024181129) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001300998) |
367500000X Nurse Anesthetist, Certified Registered (Licence: NC 105555) | |
Enumeration Date | 2006-08-18 |
Last Update Date | 2021-10-06 |