NPI | 1811953284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 812010) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 13846) |
367500000X Nurse Anesthetist, Certified Registered (Licence: AR C01485) | |
Enumeration Date | 2006-04-25 |
Last Update Date | 2015-11-02 |