NPI | 1447802301 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP142332) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 828654) |
367500000X Nurse Anesthetist, Certified Registered (Licence: TX 828654) | |
Enumeration Date | 2019-07-11 |
Last Update Date | 2022-02-22 |