NPI | 1730545658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP129935) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 75563) |
Enumeration Date | 2016-01-07 |
Last Update Date | 2024-01-26 |