NPI | 1750684619 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 60890) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119747) |
367500000X Nurse Anesthetist, Certified Registered (Licence: TX 783147) | |
Enumeration Date | 2010-12-15 |
Last Update Date | 2020-09-11 |