| NPI | 1437295524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209006493) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: IL pending) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2011-03-10 |