NPI | 1679767701 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA 2443) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 489118) |
Enumeration Date | 2007-08-31 |
Last Update Date | 2013-10-23 |