| NPI | 1114528429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6527) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L1-0042046) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2021-03-10 |