NPI | 1891382321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 131031) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1026903) |
Enumeration Date | 2020-12-30 |
Last Update Date | 2021-11-15 |