NPI | 1952587537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168857) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 132261-030) |
367500000X Nurse Anesthetist, Certified Registered (Licence: IL 077953) | |
Enumeration Date | 2008-01-14 |
Last Update Date | 2023-09-03 |