NPI | 1164126637 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2834) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2018142) |
Enumeration Date | 2023-03-29 |
Last Update Date | 2023-04-04 |