NPI | 1538468558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2011001996) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209008678) |
Enumeration Date | 2011-03-16 |
Last Update Date | 2025-03-31 |