| NPI | 1861448524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 54581) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 093647) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-11-29 |