| NPI | 1932160066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209001940) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 041235148) |
| 207L00000X Anesthesiology (Licence: IL 041.235148) | |
| 207L00000X Anesthesiology (Licence: IL 209.001940) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 209001940) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2025-12-16 |