NPI | 1699752824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP102999) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 530834) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2020-06-17 |