NPI | 1477581825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 097000628RN) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200360037crna) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2018-08-17 |