NPI | 1164794376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121486) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 87983) |
Enumeration Date | 2012-02-02 |
Last Update Date | 2022-04-14 |