NPI | 1780761239 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 147615030) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60192193) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2015-06-04 |