| NPI | 1932649878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 514428) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2012001063) |
| 163W00000X Registered Nurse (Licence: NE 77574) | |
| 163W00000X Registered Nurse (Licence: KS 13-117539-032) | |
| Enumeration Date | 2017-02-25 |
| Last Update Date | 2017-10-24 |