| NPI | 1881950350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 5084) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 160832-30) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2023-10-23 |