| NPI | 1841597150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 107) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R-1297197) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 20586-875) | |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2021-06-08 |