| NPI | 1538827928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-558018-021) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 882985) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1065206) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2022038676) | |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2022-10-12 |