NPI | 1760935456 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AK 153134) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 000000) |
Enumeration Date | 2016-07-28 |
Last Update Date | 2020-12-28 |