| NPI | 1053704270 |
|---|---|
| Former Name | DEREK ROUSE BRISSETTE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704265882) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |