NPI | 1407096597 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 082158) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 146453) |
Enumeration Date | 2009-03-02 |
Last Update Date | 2013-12-11 |