NPI | 1760787451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP119964) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 688169) |
Enumeration Date | 2011-01-11 |
Last Update Date | 2024-09-08 |