NPI | 1407894801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APRN3174) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-305802) |
367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN157615) | |
Enumeration Date | 2006-06-04 |
Last Update Date | 2009-08-17 |