NPI | 1003806811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 746391) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA00201) |
Enumeration Date | 2005-10-24 |
Last Update Date | 2013-07-11 |