NPI | 1154541589 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD CR000660) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN119798) |
Enumeration Date | 2007-04-26 |
Last Update Date | 2007-09-14 |