| NPI | 1346547445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 247) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 186998-1) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 7795-30) | |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2020-08-04 |