NPI | 1740847326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2019016285) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209025066) |
Enumeration Date | 2019-05-20 |
Last Update Date | 2025-08-13 |