NPI | 1881266971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.023868) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041431339) |
Enumeration Date | 2021-07-16 |
Last Update Date | 2023-10-11 |