NPI | 1528111325 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2011040013) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209000132) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2021-01-24 |