NPI | 1629348768 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95001290) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 725199) |
Enumeration Date | 2012-01-06 |
Last Update Date | 2020-04-09 |