NPI | 1215968961 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30004818) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 28189) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MT NUR-RN-LIC-101109) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2020-11-18 |