| NPI | 1922072925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN CRNA 1827) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 3418-33) |
| 163W00000X Registered Nurse (Licence: WI 134482-30) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP 9215489) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-10-05 |