| NPI | 1578070793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 201889) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557962-051) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2024-01-02 |