NPI | 1285314989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.031102) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.443686) |
Enumeration Date | 2023-07-19 |
Last Update Date | 2025-02-24 |