NPI | 1063165835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 3006) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 12064) |
367500000X Nurse Anesthetist, Certified Registered (Licence: WI 194157) | |
Enumeration Date | 2022-02-01 |
Last Update Date | 2024-11-07 |