NPI | 1255668661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 200483) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 083704) |
Enumeration Date | 2009-11-05 |
Last Update Date | 2021-04-16 |