NPI | 1962491365 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN281109) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 274955) |
Enumeration Date | 2005-10-18 |
Last Update Date | 2015-04-15 |