NPI | 1821139510 |
---|---|
Other Name | GLEN RAY WYANT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD490869C) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX H8898) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX H8898) | |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OK 27000) | |
Enumeration Date | 2007-02-08 |
Last Update Date | 2025-07-10 |