| NPI | 1366443285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 038488) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209026096) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2023-12-22 |