NPI | 1417933649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA rn519659l) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A00379) |
Enumeration Date | 2005-12-20 |
Last Update Date | 2018-01-19 |