NPI | 1962773283 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP121363) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 744065) |
Enumeration Date | 2012-01-18 |
Last Update Date | 2020-06-29 |