| NPI | 1467153148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209028636) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041.443514) |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2024-10-09 |