NPI | 1659675957 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119876) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 643389) |
Enumeration Date | 2010-12-29 |
Last Update Date | 2022-10-04 |