| 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 |