| NPI | 1760610166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2022032500) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-94840-072) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-556921-072) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2024-12-05 |