NPI | 1689600017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP114782) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 675709) |
Enumeration Date | 2006-06-25 |
Last Update Date | 2023-05-19 |