| NPI | 1487309175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209025584) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28299372A) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041461580) | |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2026-06-03 |