NPI | 1053735092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 1210609) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 102401) |
Enumeration Date | 2014-02-11 |
Last Update Date | 2015-03-19 |