NPI | 1477897569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1337) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2104519) |
Enumeration Date | 2012-11-15 |
Last Update Date | 2020-08-04 |