NPI | 1033195219 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP113367) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 705255) |
Enumeration Date | 2005-12-19 |
Last Update Date | 2022-01-06 |