NPI | 1205291325 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP129945) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 771324) |
Enumeration Date | 2015-12-16 |
Last Update Date | 2019-11-21 |