NPI | 1699026716 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60465497) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 5494384-3102) |
Enumeration Date | 2012-09-28 |
Last Update Date | 2014-07-28 |