| NPI | 1073843041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3853) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-109710-092) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 556943) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 140281) | |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2023-08-24 |