| NPI | 1922162593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 3420-33) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 133217-030) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2021-11-29 |