| NPI | 1003331729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2095) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: MN R-204125) |
| 208M00000X Hospitalist (Licence: MN 2041258) | |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2022-04-07 |