NPI | 1528180197 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 080916) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 04861) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2007-07-08 |