| NPI | 1164126637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2834) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2018142) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-04-04 |