NPI | 1619343639 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 232507) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5245) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2018-03-17 |