NPI | 1790039816 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2216) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209009872) |
367500000X Nurse Anesthetist, Certified Registered (Licence: IA D176311) | |
Enumeration Date | 2012-10-29 |
Last Update Date | 2023-10-25 |