NPI | 1023436003 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN238498) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 104794) |
Enumeration Date | 2014-04-07 |
Last Update Date | 2016-07-01 |