NPI | 1669636080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN528941L) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN528941L) |
Enumeration Date | 2008-07-15 |
Last Update Date | 2017-04-12 |