NPI | 1669566758 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D102258) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 102258) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2014-05-08 |