NPI | 1104870419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 2028) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC R99008) |
Enumeration Date | 2006-05-20 |
Last Update Date | 2011-06-13 |