NPI | 1851642441 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 090373) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 159353-30) |
Enumeration Date | 2012-09-24 |
Last Update Date | 2012-09-24 |