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 |