NPI | 1174512602 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN092922) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APN2487) |
Enumeration Date | 2005-10-18 |
Last Update Date | 2014-08-27 |