NPI | 1801219720 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125069) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 829384) |
Enumeration Date | 2014-01-29 |
Last Update Date | 2021-12-08 |