NPI | 1659365658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 47452) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28152575A) |
Enumeration Date | 2005-09-06 |
Last Update Date | 2014-11-15 |