| NPI | 1891388534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 1102486-30) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 132117) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2606) | |
| Enumeration Date | 2021-02-13 |
| Last Update Date | 2023-01-26 |