| NPI | 1447671656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.011048) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.362086) |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2023-08-17 |