NPI | 1740370642 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP109776) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 557932) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2022-06-21 |