NPI | 1851323042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP114727) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 630922) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2020-06-25 |