| NPI | 1801182035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 14-105503-122) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 43-557040-122) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2025-10-09 |