NPI | 1881165421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61195445) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2297) |
Enumeration Date | 2018-12-07 |
Last Update Date | 2023-04-18 |