NPI | 1891107652 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2016015976) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 114826) |
163W00000X Registered Nurse (Licence: MO 2011013251) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557258) | |
Enumeration Date | 2014-05-28 |
Last Update Date | 2019-08-20 |