NPI | 1487792131 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D-078742) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 078742) |
Enumeration Date | 2007-02-02 |
Last Update Date | 2017-03-09 |