NPI | 1508816497 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 523406) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME R045040) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2012-09-11 |