NPI | 1699229369 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209014801) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 142768-30) |
163W00000X Registered Nurse (Licence: IL 041305001) | |
Enumeration Date | 2016-08-10 |
Last Update Date | 2024-09-26 |