| NPI | 1073283230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-558056-032) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KS 112552) |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2023-01-24 |