NPI | 1023506243 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2018017254) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-116165-062) |
163W00000X Registered Nurse (Licence: MO 2010022733) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557598-062) | |
Enumeration Date | 2018-04-23 |
Last Update Date | 2020-11-09 |