| NPI | 1497385082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209022839) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 128779) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2023-01-24 |