NPI | 1003187600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121393) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 143857) |
Enumeration Date | 2012-01-13 |
Last Update Date | 2018-06-05 |