NPI | 1013973601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704208184) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4704208184) |
Enumeration Date | 2006-04-24 |
Last Update Date | 2010-11-18 |