| NPI | 1114776101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704344918) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704344918NSA2408Z) |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-09-27 |