| NPI | 1215334487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A00795) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN509935L) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2019-05-10 |