NPI | 1821199878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 155271) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557703-052) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2025-05-02 |