NPI | 1962828368 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704237177) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RC268385) |
Enumeration Date | 2014-03-10 |
Last Update Date | 2015-07-29 |