NPI | 1467510453 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN8749) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN34837) |
163W00000X Registered Nurse (Licence: GA RN048713) | |
Enumeration Date | 2006-12-04 |
Last Update Date | 2010-02-02 |