NPI | 1972503340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 931) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APN931) |
Enumeration Date | 2005-07-28 |
Last Update Date | 2016-12-21 |