NPI | 1720362999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9328944) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 667490) |
163W00000X Registered Nurse (Licence: FL 9328944) | |
Enumeration Date | 2011-10-05 |
Last Update Date | 2011-12-13 |