| NPI | 1861183154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209029883) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 144036) |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2024-06-26 |