NPI | 1376838011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 087492) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 199362) |
Enumeration Date | 2011-06-10 |
Last Update Date | 2011-06-29 |