NPI | 1891191763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 19231) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 204365) |
Enumeration Date | 2014-11-05 |
Last Update Date | 2015-01-08 |