NPI | 1659556470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP118341) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 698498) |
367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200860007CRNA) | |
Enumeration Date | 2007-12-31 |
Last Update Date | 2016-04-04 |