NPI | 1417998519 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD 028203) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R014863) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2008-05-19 |