NPI | 1255327714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP108365) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 613451) |
Enumeration Date | 2005-09-21 |
Last Update Date | 2025-09-27 |