NPI | 1851343123 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-005622) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 141905030) |
367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041313248) | |
Enumeration Date | 2006-05-16 |
Last Update Date | 2025-01-05 |