| NPI | 1396261905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 26516) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 114648) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209016529) | |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2023-01-27 |