| NPI | 1730470493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209009116) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041397136) |
| 163W00000X Registered Nurse (Licence: MO 2009007215) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2011012309) | |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2024-02-01 |