NPI | 1750792966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2047) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D136691) |
367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000441) | |
Enumeration Date | 2014-05-12 |
Last Update Date | 2024-07-05 |