| NPI | 1427337161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557418) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2011032583) |
| 163W00000X Registered Nurse (Licence: WI 167039-030) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2026-03-19 |