NPI | 1144500018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209009025) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-009025) |
363LA2100X Nurse Practitioner, Acute Care (Licence: SC 18087) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11018636) | |
Enumeration Date | 2011-08-24 |
Last Update Date | 2025-09-09 |