| NPI | 1841423605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 556928) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 140117) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KS 1393112052) | |
| 163W00000X Registered Nurse (Licence: KS 93112) | |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2010-03-17 |