NPI | 1407802127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA559) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N32502) |
Enumeration Date | 2006-05-25 |
Last Update Date | 2011-04-08 |