NPI | 1730456880 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD CR000872) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704267742) |
Enumeration Date | 2011-11-17 |
Last Update Date | 2015-02-20 |