NPI | 1124308473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-113384) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN16057) |
163W00000X Registered Nurse (Licence: TN RN169321) | |
Enumeration Date | 2011-08-18 |
Last Update Date | 2013-09-16 |