| NPI | 1437315124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209007141) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28210726A) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2020-01-29 |