NPI | 1952345399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA00964) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C00514) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2012-10-12 |