| NPI | 1922342484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209010290) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000296) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 25253) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000296) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2013006995) | |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2024-09-23 |