NPI | 1275648578 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 037557) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 114813) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2011-12-21 |