NPI | 1265402929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 717) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R131650-2) |
Enumeration Date | 2006-01-25 |
Last Update Date | 2020-10-05 |