NPI | 1437160454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VT 1010060781) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 0321772311) |
Enumeration Date | 2006-08-11 |
Last Update Date | 2011-02-04 |