| NPI | 1326288812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209007657) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041334740) |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2009-07-12 |