NPI | 1518349752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209029410) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN3074082) |
367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN3074082) | |
Enumeration Date | 2015-06-24 |
Last Update Date | 2024-07-17 |