NPI | 1427631225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.023544) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041370278) |
Enumeration Date | 2021-04-30 |
Last Update Date | 2022-04-21 |