NPI | 1366889552 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 090770) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 207783) |
163W00000X Registered Nurse (Licence: WV 77680) | |
Enumeration Date | 2013-05-28 |
Last Update Date | 2014-01-16 |