| NPI | 1891737243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 54321) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: KS 54321) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2018-11-07 |