NPI | 1790843019 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168065) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0001182005) |
Enumeration Date | 2006-12-06 |
Last Update Date | 2009-01-27 |