NPI | 1508881434 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA2969) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1100896) |
367500000X Nurse Anesthetist, Certified Registered (Licence: KY 054599) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: IN 99012653A) | |
Enumeration Date | 2006-07-13 |
Last Update Date | 2012-04-16 |