NPI | 1649237991 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 028218) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 136201) |
Enumeration Date | 2006-04-28 |
Last Update Date | 2008-05-01 |