| NPI | 1497363857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704302758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4704302758) |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2022-12-05 |