NPI | 1548010390 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1176186) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 857565) |
Enumeration Date | 2024-03-25 |
Last Update Date | 2024-10-22 |