NPI | 1730205535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP115614) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 718442) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2019-11-04 |