NPI | 1487656831 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN-232224-L) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 25NR08396100) |
Enumeration Date | 2005-08-15 |
Last Update Date | 2007-07-08 |