NPI | 1295712420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 98467) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 674661) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2019-10-16 |