NPI | 1760414213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 081002750CRNA) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 081002750RN) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2008-01-07 |