NPI | 1932612637 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP136205) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 888176) |
367500000X Nurse Anesthetist, Certified Registered (Licence: TX 117083) | |
Enumeration Date | 2017-11-16 |
Last Update Date | 2022-10-11 |