NPI | 1497238604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2240) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 120879) |
Enumeration Date | 2018-09-13 |
Last Update Date | 2018-09-28 |