| NPI | 1033492566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 180032) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 63019) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2023-03-23 |