NPI | 1467440651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO CRA-452) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 97809) |
367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP1276112) | |
Enumeration Date | 2005-10-11 |
Last Update Date | 2013-04-17 |