| NPI | 1477144699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 241099) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: WI 241099-30) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 241099-30) | |
| Enumeration Date | 2021-01-30 |
| Last Update Date | 2022-03-30 |