| NPI | 1356672612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.011204) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041313599) |
| 163W00000X Registered Nurse (Licence: CA 733392) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3896) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 6444-33) | |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2017-08-16 |