| NPI | 1144478793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R55428) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 8489503) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2024-09-13 |