| NPI | 1578934527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209013492) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 7542-33) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041.401242) | |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2024-12-20 |