| NPI | 1740803261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2020014171) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-125607-091) |
| 163W00000X Registered Nurse (Licence: MO 2016042252) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557781-091) | |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2020-06-20 |