NPI | 1104229129 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 060989-23) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA143059) |
Enumeration Date | 2014-10-04 |
Last Update Date | 2019-04-16 |