NPI | 1639342108 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP116919) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 753695) |
Enumeration Date | 2008-04-07 |
Last Update Date | 2020-06-25 |