NPI | 1336107523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3009680) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN082617) |
Enumeration Date | 2006-05-04 |
Last Update Date | 2015-10-22 |