NPI | 1043666522 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP131609) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 898070) |
Enumeration Date | 2016-05-13 |
Last Update Date | 2022-06-07 |