NPI | 1962672915 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 078679) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 714039) |
Enumeration Date | 2008-03-05 |
Last Update Date | 2009-07-30 |