| NPI | 1912230368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 4031) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 131240) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2024-10-23 |