NPI | 1710986419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA83341) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 048605-23-11) |
Enumeration Date | 2005-07-15 |
Last Update Date | 2013-06-28 |