NPI | 1861960627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP140139) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 856988) |
Enumeration Date | 2018-11-08 |
Last Update Date | 2019-01-21 |