| NPI | 1104917558 |
|---|---|
| Professional Name | MEDICINE BOW ANESTHESIA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WY 181120679) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2009-10-21 |