| NPI | 1750407201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-002135) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-271909) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2016-06-08 |