NPI | 1457774887 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125349) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP07613) |
Enumeration Date | 2014-01-21 |
Last Update Date | 2015-11-02 |