NPI | 1699873521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME 049616) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VT 0085221) |
Enumeration Date | 2006-09-21 |
Last Update Date | 2012-09-21 |