| NPI | 1467886275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557653) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 76112) |
| 363LA2100X Nurse Practitioner Acute Care (Licence: KS 76112) | |
| 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: KS 76112) | |
| 363LC1500X Nurse Practitioner Community Health (Licence: KS 76112) | |
| 363LF0000X Nurse Practitioner Family (Licence: KS 76112) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 76112) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557653) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2021039113) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 27175) | |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2023-03-29 |