NPI | 1639499130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119104) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 083079) |
Enumeration Date | 2010-06-07 |
Last Update Date | 2022-06-29 |