| NPI | 1851343123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-005622) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 141905030) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041313248) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2025-01-05 |