| NPI | 1407425283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.023430) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 090098-23) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2022-12-12 |