| NPI | 1154482693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 54220) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 42933) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2014-02-28 |