NPI | 1427240571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704231646) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MI 4704231646) |
Enumeration Date | 2007-08-13 |
Last Update Date | 2014-07-03 |