NPI | 1457318735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM CRNA00202) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R23024) |
Enumeration Date | 2006-04-28 |
Last Update Date | 2017-12-07 |