NPI | 1962455386 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP04369) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN084069) |
Enumeration Date | 2006-05-18 |
Last Update Date | 2007-07-08 |