NPI | 1790858066 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 028862) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 64569) |
Enumeration Date | 2006-11-16 |
Last Update Date | 2012-08-28 |