NPI | 1356786560 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 92879) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 244617) |
Enumeration Date | 2013-05-01 |
Last Update Date | 2013-05-18 |