NPI | 1992449094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209025486) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041440822) |
Enumeration Date | 2022-04-25 |
Last Update Date | 2024-07-14 |