NPI | 1275989006 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-032036) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 110938) |
Enumeration Date | 2016-05-11 |
Last Update Date | 2025-07-07 |