NPI | 1013211861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119816) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 722442) |
Enumeration Date | 2011-01-07 |
Last Update Date | 2020-06-08 |