| NPI | 1962990309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 268561) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041389717) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0101218-C-CRNA) | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2023-09-20 |