| NPI | 1235584053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: IL 209-023540) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2300046) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2024-01-05 |