| NPI | 1952341026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R21652) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R153023-6) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-02-22 |