NPI | 1538116074 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 021086) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP102915) |
Enumeration Date | 2006-05-30 |
Last Update Date | 2019-10-24 |