| NPI | 1083172415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557689-021) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KS 43-557689-021) |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2024-11-13 |