| NPI | 1295923985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.006942) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL RN 041-330738) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2024-10-15 |