| NPI | 1326745480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-558110-122) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 130479) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2023045682) | |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2024-09-25 |