NPI | 1669916367 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209015470) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041401444) |
Enumeration Date | 2016-12-14 |
Last Update Date | 2017-01-17 |