| NPI | 1790868677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D121780) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-84460-052) |
| 163W00000X Registered Nurse (Licence: IA 121780) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 55559) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2024-03-18 |