NPI | 1356600761 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD CR000786) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R041264) |
Enumeration Date | 2012-05-07 |
Last Update Date | 2017-03-10 |