| NPI | 1902881733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28184077A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209002579) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2015-12-21 |