| NPI | 1417341165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2015016929) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2009017310) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: KS 14-130822-071) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557335-071) | |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2024-03-07 |