NPI | 1255319000 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1123) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R-140439-1) |
Enumeration Date | 2006-01-03 |
Last Update Date | 2019-04-17 |