| NPI | 1972000438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.024897) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D167554) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2023-11-21 |