| NPI | 1437623535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2383699) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R39886) |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2022-07-13 |