| NPI | 1477614394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 110270-030) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 110270-30) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2019-03-19 |