| NPI | 1720778988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209028617) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041422907) |
| 163W00000X Registered Nurse (Licence: IN 28281380A) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041422907) | |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2024-03-07 |