NPI | 1235140005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP116127) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN283800) |
Enumeration Date | 2006-08-10 |
Last Update Date | 2020-09-04 |