| NPI | 1972736551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2024007928) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041341872) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209007627) | |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2024-09-09 |