NPI | 1770864142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 487) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 164314-9) |
Enumeration Date | 2011-08-30 |
Last Update Date | 2020-10-02 |