NPI | 1881924199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 53508) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO PENDING) |
Enumeration Date | 2010-01-08 |
Last Update Date | 2020-02-11 |