NPI | 1174896583 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121431) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 117135) |
Enumeration Date | 2012-02-15 |
Last Update Date | 2022-06-27 |