NPI | 1962072918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 144981) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NC 289166) |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 870966) | |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 95329745) | |
Enumeration Date | 2021-06-30 |
Last Update Date | 2024-12-19 |