NPI | 1275503351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 511988) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO CRNA000348) |
Enumeration Date | 2006-01-23 |
Last Update Date | 2011-05-25 |