| NPI | 1891088084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557844) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 087181) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 20891) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2022-10-31 |