NPI | 1386887263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 004706) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 551730) |
367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3783) | |
Enumeration Date | 2009-04-08 |
Last Update Date | 2018-09-14 |