NPI | 1023011574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA990) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 090352) |
Enumeration Date | 2005-05-28 |
Last Update Date | 2015-10-12 |