NPI | 1629161195 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD CR000062) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD R013966) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2013-01-03 |