NPI | 1487028221 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 7613) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN CRNA 1856) |
Enumeration Date | 2015-11-17 |
Last Update Date | 2024-06-04 |