NPI | 1619941218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN513106L) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 714305) |
Enumeration Date | 2006-02-13 |
Last Update Date | 2015-05-26 |