NPI | 1366573719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP130953) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP3071822) |
Enumeration Date | 2007-03-08 |
Last Update Date | 2020-08-17 |