| NPI | 1114991908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1564) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R117898-6) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2022-12-13 |