NPI | 1063718039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 4232) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9318829) |
Enumeration Date | 2011-02-08 |
Last Update Date | 2016-08-19 |