| NPI | 1093172132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209013780) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041395579) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2022-07-21 |