NPI | 1013254093 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 07140) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 119339) |
Enumeration Date | 2013-01-10 |
Last Update Date | 2013-01-11 |