| NPI | 1255725560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28221480A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209012662) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2025-09-15 |