NPI | 1417072034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01048) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R42741) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2013-07-26 |