| NPI | 1427644509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 1101984-30) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 14061-33) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 232468-7) | |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2024-03-19 |