| NPI | 1487028221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 7613) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN CRNA 1856) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2024-06-04 |