NPI | 1679548242 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 71673) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN332197L) |
Enumeration Date | 2006-02-17 |
Last Update Date | 2008-07-28 |