NPI | 1245559343 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D-111082) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007013208) |
163W00000X Registered Nurse (Licence: KS 14-100965-102) | |
163W00000X Registered Nurse (Licence: OK R98156) | |
Enumeration Date | 2010-05-28 |
Last Update Date | 2012-02-09 |