NPI | 1790006542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA213056) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R878585) |
Enumeration Date | 2010-06-16 |
Last Update Date | 2021-10-12 |