| NPI | 1861173817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209029939) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MO 2017023122) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041506786) | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2024-06-28 |