NPI | 1184058570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60404208) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 6445536-4406) |
Enumeration Date | 2013-08-21 |
Last Update Date | 2020-11-04 |