NPI | 1518299874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 86062) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 702703) |
Enumeration Date | 2010-02-11 |
Last Update Date | 2014-06-30 |