NPI | 1952819252 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024175974) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001276426) |
Enumeration Date | 2018-01-21 |
Last Update Date | 2018-03-21 |