NPI | 1598858524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11004272) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R1485459) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2020-02-14 |