| NPI | 1144575598 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28179329A) | 
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209009596) | 
| Enumeration Date | 2012-07-20 | 
| Last Update Date | 2025-05-07 |