NPI | 1326308917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 0843) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2264031) |
Enumeration Date | 2012-05-17 |
Last Update Date | 2020-10-02 |