| NPI | 1205005113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041-338406) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 8931-33) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2023-05-08 |