NPI | 1295079283 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-856A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 6679291) |
Enumeration Date | 2012-11-15 |
Last Update Date | 2013-02-05 |