NPI | 1477823714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121415) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 707674) |
Enumeration Date | 2012-01-04 |
Last Update Date | 2020-07-14 |