NPI | 1962132183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024190417) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R233735) |
Enumeration Date | 2022-06-11 |
Last Update Date | 2024-06-26 |