NPI | 1033420724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2010017626) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 220819) |
Enumeration Date | 2010-06-28 |
Last Update Date | 2023-08-10 |