| NPI | 1588153514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 241707-30) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 8450) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2024-07-11 |