NPI | 1336875897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209026905) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN662151) |
Enumeration Date | 2022-07-27 |
Last Update Date | 2023-08-02 |