| NPI | 1811949910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209013905) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28217746A) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2018-03-17 |