NPI | 1598388365 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1010458) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R40320) |
Enumeration Date | 2020-05-27 |
Last Update Date | 2021-01-19 |