| NPI | 1780322156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 137497) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 24652330) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 278564) | |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2022-08-23 |