NPI | 1932516044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC001430) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0033444) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 26NR14385400) | |
Enumeration Date | 2014-07-21 |
Last Update Date | 2014-12-05 |