NPI | 1215120753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 1379) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 319176) |
Enumeration Date | 2007-08-17 |
Last Update Date | 2007-08-17 |