| NPI | 1497989933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-556867-091) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-107432-091) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2010-11-16 |