NPI | 1598230377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP140142) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 832516) |
Enumeration Date | 2018-10-09 |
Last Update Date | 2020-09-11 |