| NPI | 1558020958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A10875) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA 136768) |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2022-01-31 |