| NPI | 1093882763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557052) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001197573) |
| 163W00000X Registered Nurse (Licence: KS 14117177012) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024169253) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2023-03-10 |