NPI | 1063927473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2344) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 119113) |
Enumeration Date | 2017-12-07 |
Last Update Date | 2020-10-15 |