| NPI | 1720825482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 162978) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2025016993) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 223143) | |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2025-05-30 |