NPI | 1558656918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN113308) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 139606) |
Enumeration Date | 2011-06-14 |
Last Update Date | 2011-07-18 |