NPI | 1184123499 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP136631) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 929860) |
Enumeration Date | 2018-02-02 |
Last Update Date | 2022-01-28 |