NPI | 1578540704 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP113649) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 662426) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2022-11-11 |