| NPI | 1609515832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.026205) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041476893) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 139767) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041476893) | |
| Enumeration Date | 2022-06-04 |
| Last Update Date | 2022-10-19 |