NPI | 1295723963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA00640) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 42812) |
Enumeration Date | 2005-10-07 |
Last Update Date | 2012-03-28 |