NPI | 1992109748 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000271) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 767895) |
Enumeration Date | 2014-10-22 |
Last Update Date | 2015-11-30 |