| NPI | 1093220089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 9210-33) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2182) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2019-09-10 |