NPI | 1376059287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2184) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1889327) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-12-15 |
Last Update Date | 2020-10-02 |