| NPI | 1154576569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 8989-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 68193) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 901711) | |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2024-04-25 |