NPI | 1265641310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D134055) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R158640) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2013-10-03 |