NPI | 1942812359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 294037) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN200299) |
Enumeration Date | 2020-08-18 |
Last Update Date | 2023-07-03 |