NPI | 1467626309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 1007) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 1007) |
Enumeration Date | 2008-04-22 |
Last Update Date | 2020-10-13 |