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 |