NPI | 1285636191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP131818) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000292) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2019-12-19 |