NPI | 1548505621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA4359) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 825943) |
Enumeration Date | 2012-11-30 |
Last Update Date | 2017-05-24 |