| NPI | 1023498961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557351-032) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-118413-032) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-07-08 |