NPI | 1295813558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 43888) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 166534) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2008-05-27 |