NPI | 1013097575 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN135712) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-092673) |
Enumeration Date | 2006-10-17 |
Last Update Date | 2007-07-08 |