| NPI | 1003753732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-558404-041) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-148983-041) |
| Enumeration Date | 2026-04-30 |
| Last Update Date | 2026-07-15 |