NPI | 1164579595 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP115621) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 680363) |
Enumeration Date | 2007-01-05 |
Last Update Date | 2020-09-23 |