NPI | 1205073863 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP117542) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 081136) |
Enumeration Date | 2009-01-19 |
Last Update Date | 2020-09-22 |