NPI | 1609029107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 081074) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1104576) |
Enumeration Date | 2008-10-28 |
Last Update Date | 2009-07-22 |