NPI | 1275831182 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1495) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN r 166053-3) |
Enumeration Date | 2011-03-02 |
Last Update Date | 2020-08-04 |