| NPI | 1508814013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 55152) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: KS 55152) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2024-06-28 |