NPI | 1407151913 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP06688) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9306451) |
Enumeration Date | 2011-01-13 |
Last Update Date | 2017-10-25 |