NPI | 1720010275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 094006541RN) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 094006541CRNA) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2007-07-08 |