NPI | 1518323153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000431) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704272730) |
Enumeration Date | 2016-01-12 |
Last Update Date | 2022-01-03 |