NPI | 1457335408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 726382) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 55042) |
Enumeration Date | 2005-12-02 |
Last Update Date | 2018-06-01 |