| NPI | 1427387745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2012037456) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 63533) |
| 163W00000X Registered Nurse (Licence: KS 14-594413-051) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-556966-051) | |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2024-11-07 |