NPI | 1588048029 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP129988) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 785156) |
Enumeration Date | 2015-07-15 |
Last Update Date | 2020-06-29 |