NPI | 1912946542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1230) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 165395-30) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MN R132680-6) | |
Enumeration Date | 2006-06-06 |
Last Update Date | 2020-12-21 |