| NPI | 1295491447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209024455) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041405460) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2022-05-24 |