| NPI | 1871576009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 2820-33) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 89142030) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2024-03-28 |