NPI | 1629392378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP118860) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 684097) |
Enumeration Date | 2010-03-24 |
Last Update Date | 2018-02-09 |