NPI | 1851519151 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 115) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 145934-6) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2020-10-02 |