NPI | 1164508339 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN126906) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA AANA28842) |
Enumeration Date | 2006-10-31 |
Last Update Date | 2007-07-08 |