| NPI | 1386875375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-007731) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 082460) |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2024-04-19 |