NPI | 1154686749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP122089) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 744354) |
Enumeration Date | 2012-07-10 |
Last Update Date | 2020-06-09 |