NPI | 1649258716 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 098480) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 98480) |
Enumeration Date | 2006-01-09 |
Last Update Date | 2008-11-05 |