NPI | 1942012711 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1191805) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 153414) |
Enumeration Date | 2025-01-21 |
Last Update Date | 2025-08-05 |