NPI | 1982178018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP140339) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 836156) |
Enumeration Date | 2019-01-11 |
Last Update Date | 2022-02-14 |