| NPI | 1598902181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN CRNA 2043) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 165777-30) |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2017-04-10 |