| NPI | 1265161673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.030066) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: DC RN200002478) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2024-10-24 |