| NPI | 1871604868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209006284) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041321305) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-30 |