NPI | 1013910538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP04663) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN070040) |
Enumeration Date | 2005-05-30 |
Last Update Date | 2023-02-13 |