NPI | 1447810932 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP142891) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 958409) |
Enumeration Date | 2019-06-17 |
Last Update Date | 2021-06-04 |