| NPI | 1346393345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R147003-7) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: HI APRN-4442) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2025-05-21 |