| NPI | 1477870533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 11962834-4406) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R1662984) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 483) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2021-03-17 |