| NPI | 1396286894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A00781) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0049430) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2023-08-07 |