| NPI | 1073274775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.025644) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 041.422572) |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-10-04 |