| NPI | 1477296556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209025407) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041437972) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041437972) | |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2024-03-21 |