| NPI | 1750355756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 740) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R134776-2) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2024-01-23 |