| NPI | 1902343684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 13346) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 23067) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 242437-0) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2041) | |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2023-06-07 |