NPI | 1417955220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP107713) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 541123) |
Enumeration Date | 2005-07-14 |
Last Update Date | 2021-08-11 |