NPI | 1578974465 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C003041) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR 80598) |
Enumeration Date | 2014-05-13 |
Last Update Date | 2014-07-28 |