| NPI | 1053755504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2013035076) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 794593) |
| 163W00000X Registered Nurse (Licence: MO 2010033733) | |
| 163W00000X Registered Nurse (Licence: KS 14-122922-101) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557199) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2022-05-09 |