NPI | 1184603391 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 556808) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2000147909) |
Enumeration Date | 2006-01-16 |
Last Update Date | 2018-04-09 |