NPI | 1760733554 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1135471) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 640297) |
367500000X Nurse Anesthetist, Certified Registered (Licence: NY 640297-1) | |
Enumeration Date | 2012-09-20 |
Last Update Date | 2023-11-07 |