NPI | 1942936943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209032566) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP142837) |
Enumeration Date | 2022-08-01 |
Last Update Date | 2025-09-04 |