NPI | 1306299581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000917) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041.376271) |
Enumeration Date | 2016-07-22 |
Last Update Date | 2023-10-31 |