NPI | 1225030711 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209000967) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041229591) |
Enumeration Date | 2005-08-15 |
Last Update Date | 2020-10-09 |