NPI | 1902084395 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP116503) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 659497) |
Enumeration Date | 2008-02-07 |
Last Update Date | 2022-07-08 |