| NPI | 1285037523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 6073) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 188330-30) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2020-09-15 |