| NPI | 1235462995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 157834-30) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 3073) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2025-02-10 |