NPI | 1487657904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP01969) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN030558) |
Enumeration Date | 2005-05-30 |
Last Update Date | 2022-12-15 |