| NPI | 1497729289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 230) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R085816-8) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2019-04-24 |