| NPI | 1760102347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2764) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 247851-4) |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2024-06-11 |