NPI | 1275074403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP134418) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN143859) |
163W00000X Registered Nurse (Licence: TX 786780) | |
Enumeration Date | 2017-03-20 |
Last Update Date | 2020-02-05 |