NPI | 1548995244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209027782) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 193814) |
Enumeration Date | 2022-07-18 |
Last Update Date | 2023-09-19 |