NPI | 1285690107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704198384) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4704198384) |
Enumeration Date | 2006-04-21 |
Last Update Date | 2020-01-06 |