| NPI | 1649335597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-55106) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 054030) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 147804) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2026-04-21 |