NPI | 1912671587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2639) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2251200) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MN 135316) | |
Enumeration Date | 2021-08-05 |
Last Update Date | 2021-12-02 |