| NPI | 1386157204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 10557-33) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1958481) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10021028) | |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2024-04-01 |