NPI | 1740752427 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP144070) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 848506) |
Enumeration Date | 2018-12-19 |
Last Update Date | 2021-11-22 |