NPI | 1801552161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R51646) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2363567) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2363567) | |
Enumeration Date | 2021-11-11 |
Last Update Date | 2022-03-30 |