NPI | 1821051228 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 41191003) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209003155) |
Enumeration Date | 2006-04-08 |
Last Update Date | 2007-07-08 |