NPI | 1225332521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119853) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 716616) |
Enumeration Date | 2010-12-29 |
Last Update Date | 2022-11-28 |