NPI | 1992261739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 126323) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 265717) |
Enumeration Date | 2019-02-18 |
Last Update Date | 2019-06-04 |