NPI | 1083487177 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2915) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2462590) |
Enumeration Date | 2023-11-01 |
Last Update Date | 2024-01-29 |