NPI | 1356475149 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP109896) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 050479) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2020-06-30 |