NPI | 1245760388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN696666) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 112114) |
Enumeration Date | 2017-06-12 |
Last Update Date | 2017-07-11 |