NPI | 1093078636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 657856) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-097790) |
Enumeration Date | 2012-06-19 |
Last Update Date | 2015-06-22 |