| NPI | 1952556664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1948) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.007347) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 7283) | |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2019-12-18 |