NPI | 1255875928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2028) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 242456-1) |
Enumeration Date | 2016-12-14 |
Last Update Date | 2020-10-02 |