NPI | 1972561934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5363) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN177821) |
Enumeration Date | 2006-05-01 |
Last Update Date | 2016-02-08 |