NPI | 1275924417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1191537) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AK 125601) |
363L00000X Nurse Practitioner (Licence: TX AP127410) | |
Enumeration Date | 2015-02-10 |
Last Update Date | 2025-02-25 |