NPI | 1346431418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP116096) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 688293) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2020-06-29 |