NPI | 1639265226 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD R018086) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD NP5175) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2012-01-27 |