NPI | 1912969437 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9314550) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN047503) |
Enumeration Date | 2006-04-03 |
Last Update Date | 2011-11-30 |