| NPI | 1457752230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209011978) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 209011978) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041345176) | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2025-06-24 |