NPI | 1477520542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R1402746) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD R027248) |
Enumeration Date | 2006-03-07 |
Last Update Date | 2015-02-09 |