| NPI | 1407310717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.022595) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 8057) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2024-03-06 |