| NPI | 1831145846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R122772-7) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN CRNA 1779) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-11-09 |