NPI | 1134691710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 8760841-8901) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 8760841-3102) |
367500000X Nurse Anesthetist, Certified Registered (Licence: UT 8760841-4406) | |
Enumeration Date | 2018-12-20 |
Last Update Date | 2019-01-10 |