NPI | 1689063968 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP127266) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 103208) |
Enumeration Date | 2015-01-09 |
Last Update Date | 2022-07-26 |