NPI | 1922534056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61555786) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 13119182) |
367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557501-011) | |
Enumeration Date | 2017-05-10 |
Last Update Date | 2024-09-10 |