NPI | 1407816150 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 3355062) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN3355062) |
Enumeration Date | 2006-03-26 |
Last Update Date | 2014-08-19 |