| NPI | 1487027728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557385) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 114015) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2022046624) | |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2023-09-18 |