NPI | 1558319657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP106076) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 454854) |
Enumeration Date | 2006-05-04 |
Last Update Date | 2020-07-01 |