NPI | 1558333229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 130557030) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1116) |
Enumeration Date | 2006-02-06 |
Last Update Date | 2024-03-12 |