NPI | 1083820666 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R1510560) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1588) |
367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 283516) | |
Enumeration Date | 2007-05-14 |
Last Update Date | 2023-02-08 |