NPI | 1366577314 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3434) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN586748) |
Enumeration Date | 2007-02-22 |
Last Update Date | 2014-06-09 |