NPI | 1720499809 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 103773) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 138530) |
Enumeration Date | 2014-05-12 |
Last Update Date | 2014-11-19 |