NPI | 1194707935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP100981) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 35661) |
Enumeration Date | 2005-11-17 |
Last Update Date | 2020-09-18 |