NPI | 1295291482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1006762) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 747851) |
Enumeration Date | 2019-02-13 |
Last Update Date | 2024-09-17 |