| NPI | 1255311791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R0087817) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 55476) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-01-24 |