NPI | 1457692857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2012037900) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28242075A) |
Enumeration Date | 2013-03-09 |
Last Update Date | 2020-12-14 |