NPI | 1356314330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 3419) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN517086L) |
Enumeration Date | 2006-02-09 |
Last Update Date | 2011-01-03 |