NPI | 1114222007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP120094) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 086758) |
Enumeration Date | 2011-01-24 |
Last Update Date | 2025-05-27 |