NPI | 1801870480 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28087122A) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: IN 28087122) |
Enumeration Date | 2005-12-06 |
Last Update Date | 2014-10-01 |