NPI | 1326495763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 24001) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP133000) |
Enumeration Date | 2016-05-16 |
Last Update Date | 2022-04-05 |