NPI | 1023166410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 139810) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 26721) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2007-07-08 |