NPI | 1265703789 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-955A) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201400593CRNA) |
Enumeration Date | 2012-01-13 |
Last Update Date | 2016-03-30 |