NPI | 1588846786 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 94107) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 686634) |
Enumeration Date | 2007-11-29 |
Last Update Date | 2011-08-24 |