NPI | 1679596233 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC CRNA80823) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 80823) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2010-10-15 |