| NPI | 1326131137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704194062) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 11073) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-11-17 |