NPI | 1760421838 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 663055) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 70755) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2009-03-03 |