| NPI | 1225030711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209000967) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041229591) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2020-10-09 |