NPI | 1255351391 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN071670) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN071670) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2014-11-18 |