NPI | 1316319379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 700515) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN651410) |
163W00000X Registered Nurse (Licence: OH RN.410503) | |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 575773) | |
Enumeration Date | 2015-10-29 |
Last Update Date | 2015-12-28 |