| NPI | 1386353506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-558228-071) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0100389-C-CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2025006825) | |
| 163W00000X Registered Nurse (Licence: NE 75130) | |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2025-09-24 |