| NPI | 1922534056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61555786) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 13119182) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557501-011) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2024-09-10 |