NPI | 1275746984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1390) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 140825-8) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2020-10-05 |