Individual
MATAR GOUMBALA
Active
Individual
MATAR GOUMBALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
13346
WI
367500000X
Certified Registered Nurse Anesthetist
2041
MN
367500000X
Certified Registered Nurse Anesthetist
23067
WI
367500000X
Certified Registered Nurse Anesthetist
242437-0
MN
Other
Enumeration date
01/19/2017
Last updated
06/07/2023
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