NPI | 1174579692 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA406) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N27389) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2011-04-07 |