NPI | 1588864698 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 19786) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ANT 9229059) |
Enumeration Date | 2007-07-18 |
Last Update Date | 2017-05-03 |