NPI | 1144658709 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.015724) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN339071) |
Enumeration Date | 2013-10-17 |
Last Update Date | 2017-04-26 |