NPI | 1215993035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 547294) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 1641) |
Enumeration Date | 2006-04-21 |
Last Update Date | 2008-01-26 |