NPI | 1265739379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1553) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 144420-9) |
Enumeration Date | 2011-02-25 |
Last Update Date | 2020-10-01 |