| NPI | 1477526051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 1240) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R-132085-7) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-10-02 |