| NPI | 1194775957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209004510) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 99015186A) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-04-20 |