NPI | 1851651830 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP124850) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 643199) |
Enumeration Date | 2012-05-23 |
Last Update Date | 2020-09-22 |