| NPI | 1285973404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN CRNA 1992) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9266978) |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2017-04-26 |