NPI | 1487061636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IL 2090121874) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9296749) |
Enumeration Date | 2014-07-21 |
Last Update Date | 2015-01-08 |