NPI | 1780724419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 63318) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID N-26821) |
367500000X Nurse Anesthetist, Certified Registered (Licence: WA MB2468470) | |
Enumeration Date | 2007-02-08 |
Last Update Date | 2023-01-31 |