NPI | 1780683821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024166414) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001150060) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2008-08-14 |