NPI | 1447600010 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1120723) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1934) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 235004-6) | |
Enumeration Date | 2016-06-15 |
Last Update Date | 2024-01-22 |