NPI | 1104928068 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 664987) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP04179) |
Enumeration Date | 2006-09-02 |
Last Update Date | 2014-10-13 |