| NPI | 1053552026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R148065-8) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0100048-C-CRN) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2024-10-02 |