NPI | 1992398705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101647) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 82464) |
Enumeration Date | 2021-02-12 |
Last Update Date | 2022-09-28 |