NPI | 1124278791 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 586088-1) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NO12302900) |
Enumeration Date | 2008-09-19 |
Last Update Date | 2013-05-19 |