NPI | 1063868479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 202004533) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 60656552) |
Enumeration Date | 2016-05-05 |
Last Update Date | 2020-06-09 |